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Descriptions of pain in elderly patients following orthopaedic surgery.

Journal article
Authors Ingrid Bergh
Magnus Gunnarsson
Jens Allwood
Anders Odén
Björn Sjöström
Bertil Steen
Published in Scandinavian journal of caring sciences
Volume 19
Issue 2
Pages 110-8
ISSN 0283-9318
Publication year 2005
Published at Department of Linguistics
Institute of Community Medicine, Dept of Geriatric Medicine
Institute of Health Care Pedagogics
Pages 110-8
Language en
Links dx.doi.org/10.1111/j.1471-6712.2005...
https://gup.ub.gu.se/file/119409
Keywords Aged, psychology, Aged, 80 and over, Arthroplasty, Replacement, Hip, adverse effects, Attitude to Health, Communication, Fear, Female, Geriatric Assessment, Health Services Needs and Demand, Hospitals, University, Humans, Male, Mental Status Schedule, Osteoarthritis, Hip, surgery, Pain Measurement, methods, psychology, standards, Pain, Postoperative, diagnosis, etiology, prevention & control, psychology, Professional-Patient Relations, Questionnaires, Semantics, Statistics, Nonparametric, Sweden
Subject categories Older people and ageing

Abstract

The aims of this study were to investigate what words elderly patients, who had undergone hip surgery, used to describe their experience of pain in spoken language and to compare these words with those used in the Short-Form McGill Pain Questionnaire (SF-MPQ) and Pain-O-Meter (POM). The study was carried out at two orthopaedic and two geriatric clinical departments at a large university hospital in Sweden. Altogether, 60 patients (mean age =77) who had undergone orthopaedic surgery took part in the study. A face-to-face interview was conducted with each patient on the second day after the operation. This was divided into two parts, one tape-recorded and semi-structured in character and one structured interview. The results show that a majority of the elderly patients who participated in this study verbally stated pain and spontaneously used a majority of the words found in the SF-MPQ and in the POM. The patients also used a number of additional words not found in the SF-MPQ or the POM. Among those patients who did not use any of the words in the SF-MPQ and the POM, the use of the three additional words 'stel' (stiff), 'hemsk' (awful) and 'rad(d)(sla)' (afraid/fear) were especially marked. The patients also combined the words with a negation to describe what pain was not. To achieve a more balanced and nuanced description of the patient's pain and to make it easier for the patients to talk about their pain, there is a need for access to a set of predefined words that describe pain from a more multidimensional perspective than just intensity. If the elderly patient is allowed, and finds it necessary, to use his/her own words to describe what pain is but also to describe what pain is not, by combining the words with a negation, then the risk of the patient being forced to choose words that do not fully correspond to their pain can be reduced. If so, pain scales such as the SF-MPQ and the POM can create a communicative bridge between the elderly patient and health care professionals in the pain evaluation process.

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